Posturally-evoked vomiting (PEV) dissociated from vertigo was present in two patients with proven posterior fossa mass lesions. In both instances PEV was a major aspect of the patients' symptomatology before other findings clearly indicated the presence of an infratentorial mass lesion. A distinction is drawn between benign postural vertigo, which almost always indicates a benign disorder of the peripheral vestibular apparatus, and PEV which indicates a central lesion within the posterior fossa. A possible anatomic-physiologic basis is offered for PEV, based on the dissociation of the “vestibular syndrome,” in which PEV increases while vertigo and nystagmus diminish.
DrachmanDA: Dizziness and vertigo, in BeesonPBMcDermottW, (eds): Textbook of Medicine, ed 14. Philadelphia, W.B. Saunders Co, 1975, pp 621–626
3.
BárányR: Diagnose von krankheitser-scheinungen im bereiche des otolithenap-parates. Acta Otolaryngol (Stockh)2: 434–457, 1921
4.
NylenCO: The oto-neurological diagnosis of tumors of the brain. Acta Otolaryngol [Suppl] (Stockh)31: 7–151, 1939
5.
HarrisonMSOzsahinogluC: Positional vertigo: Aetiology and clinical significance. Brain95: 369–372, 1972
6.
Riesco-MacClureJS: Central vestibular syndrome of the midline structures in the posterior fossa, in GrahamAB, (ed): Sensorineural Hearing Processes and Disorders. Boston, Little Brown and Co, 1967, pp 283–293
7.
HartCW: Evaluation of vestibular function in health and disease, in MaloneyWH, (ed): Otolaryngology. Hagerstown, Harper and Row Pub Inc, 1972, Vol 1, pp 1–63
